Wednesday, October 21, 2015

ECDC Rapid Risk Assessment On MERS-CoV & The Jordanian Cluster

# 10,647

Although Jordan trails far behind Saudi Arabia, South Korea, and the UAE in the number of MERS cases (n=35), most of their cases have centered around hospitals, and over the past couple of months 16 new cases have been announced.

This becomes an even greater concern when you consider that Jordan is a popular medical tourism destination, receiving as many as 250,000 international visitors each year seeking medical care.

Today the ECDC has published their 21st Rapid Risk Assessment on MERS, taking into account the recurring outbreaks in Jordan. These updates also provide some of the most detailed epidemiological information available on MERS, and are highly recommended.

First the press summary, followed by a few excerpts from the latest assessment.

Note: Although dated today, this document appears to be current only through October 13th, and does not include details on the Riyadh Household cluster we’ve been following for more than a week.

The most recent Middle East respiratory syndrome (MERS) outbreak in Jordan is not unexpected although is of concern, concludes an updated rapid risk assessment.

Given the continuous occurrence of MERS cases in the Middle East and the substantial number of people travelling between the region and EU countries, sporadic importation of MERS cases to EU/EEA Member States can be expected. The majority of the MERS cases continue to be reported from the Middle East. A total of 15 cases have been reported in Europe, the last in Germany in March 2015.

The majority of the reported cases in the current outbreak in Jordan have an exposure history involving a hospital with an admitted confirmed MERS case. The role of hospitals as amplifiers of MERS-CoV infection is now well known. The risk of importation of cases to EU/EEA Member States from Jordan is considered low.

Those travelling to Middle Eastern countries should be made aware that MERS-CoV is currently circulating in the region, and that transmission in hospital settings is still one of the main sources of infection. EU citizens should also be reminded that the risk of infection can be reduced by taking simple infection prevention measures.

The World Health Organization does not recommend travel restrictions in relation to MERS-CoV.

Should someone infected with MERS-CoV enter Europe, they are likely to present themselves to a healthcare facility. The risk of nosocomial spread highlights the need for awareness among healthcare workers, stringent infection control precautions, early detection through functioning testing algorithms and preparedness planning.

The risk of widespread transmission of MERS-CoV in the community after sporadic importation into the EU/EEA remains low.

The majority of the MERS cases continue to be reported from the Middle East. Given the continuous occurrence of MERS cases in the Middle East and the substantial number of people travelling between the region and EU countries, sporadic importation of MERS cases to EU/EEA Member States can be expected.

The last reported MERS case in Europe was in Germany in March 2015. The most recent outbreak in Jordan is not unexpected although is of concern. The majority of the reported cases have an exposure history involving a hospital with an admitted confirmed MERS case. The role of hospitals as amplifiers of MERS-CoV infection is now well known. The outbreak in Jordan is centred on hospitals in Amman.

The importation of cases to EU/EEA Member States from Jordan is considered low. WHO does not recommend travel restrictions in relation to MERS-CoV, but rather recommends raising awareness among travellers to and from affected countries. EU citizens travelling to Middle Eastern countries need to be made aware that MERS-CoV is currently circulating in the region, and that transmission in hospital settings is still one of the main sources of infection.

EU citizens should also be reminded that the risk of infection can be reduced by taking simple infection prevention measures. Should someone infected with MERS-CoV enter Europe, they are likely to present themselves to a healthcare facility. The risk of nosocomial spread highlights the need for awareness among healthcare workers, stringent infection control precautions, early detection through functioning testing algorithms and preparedness planning.

The risk of widespread transmission of MERS-CoV in the community after sporadic importation into the EU/EEA remains low. Previously issued advice for travellers, including pilgrims, and healthcare workers remains valid.